Clinician
A 48-year-old with long-standing otosclerosis and worsening clarity
A 48-year-old with known otosclerosis returns reporting that hearing has worsened and that speech now sounds unclear, not just quiet. Otoscopy is normal. The question is whether a sensorineural component has developed.
Investigations
Audiogram
Tympanogram
Shallow type As tympanogram, absent reflexes. The audiogram now shows an air-bone gap sitting on top of elevated bone-conduction thresholds.